Prediction of benefit from carotid endar terectomy in individual patients: a risk-modelling study

Rothwell, P M; Warlow, C P

doi:10.1016/s0140-6736(98)11415-0

Cited by 381 publications

(256 citation statements)

References 22 publications

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“…Thus, it would be fairly straightforward for the health economics modellers in the project group to build a decision model reflecting the process of referral and care in a stroke prevention service applicable to individual patients, with guidance from the clinical and radiological incorporating the data on the effectiveness of carotid surgery in different patient groups, 61 the accuracy of non-invasive tests and their combination (obtained from the systematic review and individual patient data meta-analysis), costings (obtained from the literature and data from participating departments), timings (obtained from participating departments and a survey of practice in specific UK centres) to model speed of investigation as well as accuracy (i.e. onestop clinics versus traditional management pathways).…”

Section: The Approach To Economic Modellingmentioning

confidence: 99%

Accurate, practical and cost-effective assessment of carotid stenosis in the UK

Wardlaw

Chappell²,

Stevenson³

et al. 2006

Health Technol Assess

137

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Non-UK purchasers will have to pay a small fee for post and packing. For European countries the cost is £2 per monograph and for the rest of the world £3 per monograph.You can order HTA monographs from our Despatch Agents:-fax (with credit card or official purchase order) -post (with credit card or official purchase order or cheque) -phone during office hours (credit card only).Additionally the HTA website allows you either to pay securely by credit card or to print out your order and then post or fax it. NHS libraries can subscribe free of charge. Public libraries can subscribe at a very reduced cost of £100 for each volume (normally comprising 30-40 titles). The commercial subscription rate is £300 per volume. Please see our website for details. Subscriptions can only be purchased for the current or forthcoming volume. Contact details are as follows: Payment methods Paying by chequeIf you pay by cheque, the cheque must be in pounds sterling, made payable to Direct Mail Works Ltd and drawn on a bank with a UK address. Paying by credit cardThe following cards are accepted by phone, fax, post or via the website ordering pages: Delta, Eurocard, Mastercard, Solo, Switch and Visa. We advise against sending credit card details in a plain email. Paying by official purchase orderYou can post or fax these, but they must be from public bodies (i.e. NHS or universities) within the UK. We cannot at present accept purchase orders from commercial companies or from outside the UK. How do I get a copy of HTA on CD?Please use the form on the HTA website (www.hta.ac.uk/htacd.htm). Or contact Direct Mail Works (see contact details above) by email, post, fax or phone. HTA on CD is currently free of charge worldwide.The website also provides information about the HTA Programme and lists the membership of the various committees. HTA NHS R&D HTA ProgrammeT he research findings from the NHS R&D Health Technology Assessment (HTA) Programme directly influence key decision-making bodies such as the National Institute for Health and Clinical Excellence (NICE) and the National Screening Committee (NSC) who rely on HTA outputs to help raise standards of care. HTA findings also help to improve the quality of the service in the NHS indirectly in that they form a key component of the 'National Knowledge Service' that is being developed to improve the evidence of clinical practice throughout the NHS.The HTA Programme was set up in 1993. Its role is to ensure that high-quality research information on the costs, effectiveness and broader impact of health technologies is produced in the most efficient way for those who use, manage and provide care in the NHS. 'Health technologies' are broadly defined to include all interventions used to promote health, prevent and treat disease, and improve rehabilitation and long-term care, rather than settings of care.The HTA Programme commissions research only on topics where it has identified key gaps in the evidence needed by the NHS. Suggestions for topics are actively sought from people working in the NHS,...

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Section: The Approach To Economic Modellingmentioning

confidence: 99%

Accurate, practical and cost-effective assessment of carotid stenosis in the UK

Wardlaw

Chappell²,

Stevenson³

et al. 2006

Health Technol Assess

137

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“…1 The degree of luminal stenosis caused by atherosclerotic plaque in the carotid artery is considered an important risk factor of stroke, and the percentage of luminal stenosis degree is used for the choice of the therapeutic approach. [2][3][4] However, the severity of carotid stenosis is no longer considered sufficient for identifying patients at high risk for developing an acute cerebrovascular event. The identification of unstable plaque features in vivo may contribute to risk stratification of patients with asymptomatic and moderately severe symptomatic carotid stenosis.…”

mentioning

confidence: 99%

Carotid Artery Plaque Classification: Does Contrast Enhancement Play a Significant Role?

Saba¹,

Piga²,

Raz

et al. 2012

AJNR Am J Neuroradiol

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“…At present, degree of stenosis and symptomatology are the main grounds to perform carotid endarterectomy (CEA). Pooled analysis of large randomized controlled trials showed that CEA is highly beneficial for symptomatic patients with high-grade (>70%) stenosis, reducing the 5-year absolute risk of ipsilateral ischemic stroke with 16% [3]. However, in patients with moderate (50% to 69%) carotid stenosis, the 5-year absolute risk reduction of ipsilateral stroke is only 4.6%, whereas CEA has no effect in symptomatic patients with mild (30% to 49%) carotid stenosis [3].…”

Section: Introductionmentioning

confidence: 99%

“…Pooled analysis of large randomized controlled trials showed that CEA is highly beneficial for symptomatic patients with high-grade (>70%) stenosis, reducing the 5-year absolute risk of ipsilateral ischemic stroke with 16% [3]. However, in patients with moderate (50% to 69%) carotid stenosis, the 5-year absolute risk reduction of ipsilateral stroke is only 4.6%, whereas CEA has no effect in symptomatic patients with mild (30% to 49%) carotid stenosis [3]. Studies of atherosclerosis encompass a broad range of phenotypes, including clinical events such as stroke or myocardial infarction, transient ischemic attacks or unstable coronary syndromes, and measurements derived from noninvasive assays with the use of lumenography, ultrasound, CT, or MRI.…”

Section: Introductionmentioning

confidence: 99%

Relation between Carotid Stenosis Severity, Plaque Echogenicity Characteristics and IMT Assessed by Ultrasound in the Community Population of Southern China

Liao¹,

Hong²,

Wang³

2015

OALib

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Carotid artery atherosclerosis (CAA) is one of the major high-risk mechanisms of stroke. Relationship between IMT, carotid plaque echogenicity and carotid stenosis assessed by ultrasound has not been systemically studied, especially in subjects with mild to moderate carotid stenosis. In this study we measured these 3 different ultrasound-derived quantitative traits concurrently in the community population of southern China and compared their associations. We found that IMTmean in the non-stenosis group (0%), <30% group and ≥30% group were 0.72 ± 0.11 mm, 0.85 ± 0.13 mm, 0.90 ± 0.17 mm respectively. IMT mean of the <30% group and ≥30% group were higher than that of 0% group (P < 0.01), ≥30% group was higher than <30% group (P < 0.01). IMT mean in the no-plaque group, hyperechoic group and hypoechoic group were 0.75 ± 0.13 mm, 0.87 ± 0.17 mm, 0.84 ± 0.15 mm respectively. IMT mean of the hyperechoic group and the hypoechoic group was higher than that of the no-plaque group (P < 0.01), IMT mean of the hypoechoic group was lower than that of the hyperechoic group, though with no statistic significance (P = 0.58). The proportion of hyperechoic or hypoechoic plaque in the <30% group was higher than that in the non-stenosis group (P < 0.01), as well as proportion of hypoechoic plaque in the ≥30% group was higher than that in the <30% group (P < 0.01). Our study indicated that there is definite correlation between stenosis severity, plaque echogenicity characteristics and IMT in evaluation the extent of CAA with ultrasound. The result suggests that the 3 different ultrasound-derived quantitative traits, are a progressing process, and this process increases the risk of stroke, thus medical treatment especially stabilizing the plaques is necessary.

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Prediction of benefit from carotid endar terectomy in individual patients: a risk-modelling study

Cited by 381 publications

References 22 publications

Accurate, practical and cost-effective assessment of carotid stenosis in the UK

Accurate, practical and cost-effective assessment of carotid stenosis in the UK

Carotid Artery Plaque Classification: Does Contrast Enhancement Play a Significant Role?

Relation between Carotid Stenosis Severity, Plaque Echogenicity Characteristics and IMT Assessed by Ultrasound in the Community Population of Southern China

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